Organization Active NPI

Northwoods Family Practice, LLC.

  • Family Medicine Physician
  • North Charleston, SC
National Provider Identifier
1003916396
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8193 Issued in SC
Legal business name
NORTHWOODS FAMILY PRACTICE, LLC.
Practice address
9313 Medical Plaza Dr
Suite 302
North Charleston, SC 29406-9155
Phone
(843) 553-0484
Fax
(843) 569-1556
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Flournoy Colzey Walker III, M.D.
Title
Doctor
Phone
(843) 553-0484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 8193 SC Primary

Addresses

Primary practice location

9313 Medical Plaza Dr
Suite 302
North Charleston, SC 29406-9155

Mailing address

9313 Medical Plaza Dr
Suite 302
North Charleston, SC 29406-9155
Phone (843) 553-0484

Other identifiers 1

IdentifierTypeStateIssuer
GP0415MedicaidSC

National Provider Directory

National Provider Directory

Locations

7301 Rivers Ave
Ste 140
North Charleston, SC 29406
Phone (843) 553-0484

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1003916396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9313 MEDICAL PLAZA DR",
            "address_2": "SUITE 302",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069155",
            "telephone_number": "843-553-0484",
            "fax_number": "843-569-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9313 MEDICAL PLAZA DR",
            "address_2": "SUITE 302",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069155",
            "telephone_number": "843-553-0484",
            "fax_number": "843-569-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWOODS FAMILY PRACTICE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "FLOURNOY",
        "authorized_official_middle_name": "COLZEY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "843-553-0484",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "8193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0415",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.